Patient Information Booklet Hysterosalpingo-Contrast- Sonography (HyCoSy)

1. WHAT IS A HYSTEROSALPINGO-CONTRAST-SONOGRAPHY (HyCoSY)?

HyCoSy examination assesses the patency of the fallopian tubes. Occluded tubes may have resulted from previous pelvic infections, fibroids, severe endometriosis, previous appendicitis and pelvic adhesions. Sometimes the cause is unknown.

This will be done using either saline (salt water), or a special foam agent that shows the fallopian tubes under ultrasound guidance.

2. WHEN SHOULD YOU MAKE AN APPOINTMENT?

You should phone to make an appointment on the first day of your next period, (if this is at the weekend phone on Monday) because it is best to have an appointment within the first 18 days of your menstrual period, but after you have stopped bleeding. Please rebook your appointment if you are still spotting as the HyCoSy will need to be cancelled if there any residual bleeding.

3. WHEN CAN THIS EXAMINATION BE PERFORMED?

A HyCoSy is normally performed between day 5 and 11 of the menstrual cycle. It is best to book the test at least 24hours after the bleeding stops and before ovulation. The test however can be done up to day 18 if you have abstained from sexual intercourse since the first day of your period.

This test cannot be performed if you are pregnant. This procedure can result in a miscarriage if performed during.

You must avoid having sexual intercourse(abstain) from the first day of your period up until the date the HyCoSy is performed.

If you have irregular periods or no periods, 2 weeks of abstinence is needed prior to the HyCoSY.

5. WHAT PREPARATION WHAT DO YOU NEED TO DO?

There is no special preparation for this examination other than the timing as described above.

If you have an ongoing pelvic infection the test cannot be performed. Please ask to speak to a doctor if this is the case.

6. WHAT WILL HAPPEN DURING THE EXAMINATION?

You will be asked to change into a hospital gown.
A sample pot will be given to you for a urine sample as we may do a pregnancy test (please come with a full bladder).
Our consultant will take a brief history from you and consent you for the procedure.
An internal (transvaginal) ultrasound will be performed first to ensure normal findings in the uterus (womb), ovaries and no signs of pelvic collections or infections.
You will be asked to lie on the examination table and the consultant will insert an instrument called a speculum into the vagina to hold the walls apart so that the cervix can be seen (the same procedure as having a smear test performed). A small thin soft tube will be will be inserted into the cervix and liquid (saline or foam) will then be injected slowly into your uterus.
The speculum is then removed and the transvaginal probe is again inserted The flow of the contrast is monitored with the ultrasound until the liquid is seen passing along the fallopian tubes and eventually (if there are no blockages) spilling out at the ends into the pelvis. You may experience some discomfort with mild ‘period-like’ cramps as the contrast is injected. This should not be severe and generally settles quickly.
The procedure takes about 30-45 minutes.

7. WHAT CONTRAST FLUID IS USED DURING THE EXAMINATION?

The contrasts used during HyCoSy include simple saline solution that is ‘agitated’ to create bubbles which appear bright on ultrasound or a special contrast liquid called ExEm Foam which is specifically designed for HyCoSy’s.

8. AFTER THE EXAMINATION

The radiologist will explain the provisional findings to you after the examination.
We will show you to a bathroom where you can freshen up. You will be given a sanitary pad.

After the examination there may be some blood stained discharge for up to 48 hours following the test. This is the contrast fluid draining from the uterus and vagina and is completely normal. A sanitary pad should be worn to allow the fluid to escape. You must not use tampons as this can increase risk of infection. Most women have no problems following the procedure but some may experience mild period-type pain afterwards. Take two of your normal painkillers such as paracetamol/Ibuprofen.

After the examination you can resume your normal activities.
You may start having sexual intercourse on the same day as your HyCoSy unless instructed otherwise on the day.

9. WHAT ARE THE POSSIBLE RISKS OR COMPLICATIONS?

Everything possible will be done to ensure your safety and comfort but, as with all medical procedures, there is a risk of some complications. These are rare, but you should be aware of them before your appointment. They include:

Infection risk of 1 in 100 (1%). You will be given a dose of antibiotics to reduce this risk.
If you have a history of pelvic infection, this may be reactivated. If you have any smelly discharge, raised temperature or pain within 48 hours following the examination, please inform your GP so that any infection can be treated. This occurs very rarely.

Some women can feel faint during or after the examination.
Very occasionally the test cannot provide all of the required information and the findings may need to be further evaluated, possibly with a hysterosalpingogram (HSG), laparoscopy or hysteroscopy.

If you require further information about risks or complications, please discuss with your referrer prior to your appointment, alternatively you can speak with the doctors when you arrive for the procedure.

WE CARE ABOUT YOUR CARE!

This leaflet will answer some of the questions that you may have but if there is anything that you and your family are not sure about then please ask your referring consultant, or feel free to contact Dr Kashef or OneWelbeck Women’s Health directly.

Patient Information Booklet Hysterosalpingo-Contrast- Sonography (HyCoSy)

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